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Promoting Physical Activity Among Older People in Hospital

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The Palgrave Handbook of Ageing and Physical Activity Promotion

Abstract

This chapter outlines the issues and strategies for optimising the implementation of physical activity programmes for older people in hospital. It begins with an overview of the hospital environment and a profile of older people admitted to hospital, including how active they are. The research literature relating to the functional consequences of bed rest and factors influencing activity levels of older people in hospital is then reviewed. Barriers to physical activity at the level of the hospital system, staff and the older person are discussed. Following this, strategies to promote physical activity are presented along with learnings from the field of implementation science. Programmes should be tailored to individuals, integrated into existing workflows, and multi-faceted to optimise effectiveness.

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References

  • Agmon, M., Zisberg, A., Gil, E., Rand, D., Gur-Yaish, N., & Azriel, M. (2017). Association between 900 steps a day and functional decline in older hospitalized patients. JAMA Internal Medicine, 177(2), 272–274.

    Article  Google Scholar 

  • Astrand, A., Saxin, C., Sjoholm, A., Skarin, M., Linden, T., Stoker, A., et al. (2016). Poststroke physical activity levels no higher in rehabilitation than in the acute hospital. Journal of Stroke and Cerebrovascular Diseases, 25(4), 938–945. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.046.

    Article  Google Scholar 

  • Australian Institute of Health and Welfare. (2012). Australian Hospital Statistics 2010–11. Health services series no. 43. Cat. no. HSE 117. Retrieved from Canberra.

    Google Scholar 

  • Australian Institute of Health and Welfare. (2016). Australia’s health 2016. Australia’s health series no. 15. Cat. no. AUS 199. Canberra: AIHW.

    Google Scholar 

  • Boltz, M., Resnick, B., Capezuti, E., Shuluk, J., & Secic, M. (2012). Functional decline in hospitalized older adults: Can nursing make a difference? Geriatric Nursing, 33(4), 272–279. https://doi.org/10.1016/j.gerinurse.2012.01.008.

    Article  Google Scholar 

  • Brown, C. J., Friedkin, R. J., & Inouye, S. K. (2004). Prevalence and outcomes of low mobility in hospitalized older patients. Journal of the American Geriatrics Society, 52(8), 1263–1270. https://doi.org/10.1111/j.1532-5415.2004.52354.x.

    Article  Google Scholar 

  • Brown, C. J., Williams, B. R., Woodby, L. L., Davis, L. L., & Allman, R. M. (2007). Barriers to mobility during hospitalization from the perspectives of older patients and their nurses and physicians. Journal of Hospital Medicine, 2(5), 305–313. https://doi.org/10.1002/jhm.209.

    Article  Google Scholar 

  • Buttery, A. K., & Martin, F. C. (2009). Knowledge, attitudes and intentions about participation in physical activity of older post-acute hospital inpatients. Physiotherapy, 95(3), 192–198. https://doi.org/10.1016/j.physio.2009.03.002.

    Article  Google Scholar 

  • Buurman, B. M., Hoogerduijn, J. G., de Haan, R. J., Abu-Hanna, A., Lagaay, A. M., Verhaar, H. J., et al. (2011). Geriatric conditions in acutely hospitalized older patients: Prevalence and one-year survival and functional decline. PLoS One, 6(11), e26951. https://doi.org/10.1371/journal.pone.0026951.

    Article  Google Scholar 

  • Convertino, V. A. (1997). Cardiovascular consequences of bed rest: Effect on maximal oxygen uptake. Medicine and Science in Sports and Exercise, 29(2), 191.

    Article  Google Scholar 

  • Convertino, V., Hung, J., Goldwater, D., & Debusk, R. F. (1982). Cardiovascular responses to exercise in middle-aged men after 10 days of bedrest. Circulation, 65(1), 134.

    Article  Google Scholar 

  • Convertino, V. A., Bloomfield, S. A., & Greenleaf, J. E. (1997). An overview of the issues: Physiological effects of bed rest and restricted physical activity. Medicine and Science in Sports and Exercise, 29(2), 187.

    Article  Google Scholar 

  • Cosby, J. L. (2006). Improving patient care: The implementation of change in clinical practice. Elsevier: BMJ Publishing Group.

    Google Scholar 

  • Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., et al. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: Increased vulnerability with age. Journal of the American Geriatrics Society, 51(4), 451–458.

    Article  Google Scholar 

  • Davenport, S. J., Arnold, M., Hua, C., Schenck, A., Batten, S., & Taylor, N. F. (2015). Physical activity levels during acute inpatient admission after hip fracture are very low. Physiotherapy Research International, 20(3), 174–181.

    Article  Google Scholar 

  • de Morton, N. A., Nolan, J., O’Brien, M., Thomas, S., Govier, A., Sherwell, K., et al. (2015). A head-to-head comparison of the de Morton mobility index (DEMMI) and elderly mobility scale (EMS) in an older acute medical population. Disability and Rehabilitation, 37(20), 1881. https://doi.org/10.3109/09638288.2014.982832.

    Article  Google Scholar 

  • Despond, O., Buchser, E., Sprunger, A. L., & Sloutkis, D. (1999). Influence of patient’s dressing on spontaneous physical activity and length of hospital stay in surgical patients. Sozial-und Präventivmedizin, 44(1), 8–13.

    Article  Google Scholar 

  • Dewing, J. (2001). Care for older people with a dementia in acute hospital settings. Nursing Older People, 13(3), 18–20. PubMed PMID: 12008241.

    Article  Google Scholar 

  • Fisher, S. R., Graham, J. E., Ottenbacher, K. J., Deer, R., & Ostir, G. V. (2016). Inpatient walking activity to predict readmission in older adults. Archives of Physical Medicine and Rehabilitation, 97(9 Suppl), S226–S231. https://doi.org/10.1016/j.apmr.2015.09.029.

    Article  Google Scholar 

  • Gasior, K. (2012). In R. Rodrigues, M. Huber, & G. Lamura (Eds.), Facts and figures on healthy ageing and long-term care, Europe and North America, Occasional reports series 8. Vienna: European Centre.

    Google Scholar 

  • Gill, T. M., Allore, H. G., Gahbauer, E. A., & Murphy, T. E. (2010). Change in disability after hospitalization or restricted activity in older persons. JAMA, 304(17), 1919–1928. https://doi.org/10.1001/jama.2010.1568.

    Article  Google Scholar 

  • Gorgon, E., Said, C., & Galea, M. (2007). Mobility on discharge from an aged care unit. Physiotherapy Research International, 12(2), 72.

    Article  Google Scholar 

  • Hall, M. J., DeFrances, C. J., Williams, S. N., Golosinskiy, A., & Schwartzman, A. (2010). National Hospital Discharge Survey: 2007 summary. National Health Statistics Reports, 29(1–20), 24.

    Google Scholar 

  • Hastings, S. N., Sloane, R., Morey, M. C., Pavon, J. M., & Hoenig, H. (2014). Assisted early mobility for hospitalized older veterans: Preliminary data from the STRIDE program. Journal of the American Geriatrics Society, 62(11), 2180–2184. https://doi.org/10.1111/jgs.13095.

    Article  Google Scholar 

  • Hirsch, C. H., Sommers, L., Olsen, A., Mullen, L., & Winograd, C. H. (1990). The natural history of functional morbidity in hospitalized older patients. Journal of the American Geriatrics Society, 38(12), 1296–1303. https://doi.org/10.1111/j.1532-5415.1990.tb03451.x.

    Article  Google Scholar 

  • Hirshon, J. M., Risko, N., Calvello, E. J. B., de Ramirez, S. S., Narayan, M., Theodosis, C., & Oneill, J. (2013). Health systems and services: The role of acute care. (Perspectives). Bulletin of the World Health Organization, 91(5), 386.

    Article  Google Scholar 

  • Holst, M., Hansen, P. L., Pedersen, L. A., Paulsen, S., Valentinsen, C. D., & Kohler, M. (2015). Physical activity in hospitalised elderly medical patients: How active are they, and what motivates to physical activity. Journal of Aging Research and Clinical Practice, 4(2), 116–123.

    Google Scholar 

  • Izawa, K. P., Watanabe, S., Oka, K., Osada, N., Omiya, K., Brubaker, P. H., & Shimizu, H. (2014). Differences in daily in-hospital physical activity and geriatric nutritional risk index in older cardiac inpatients: Preliminary results. Aging Clinical and Experimental Research, 26(6), 599–605. https://doi.org/10.1007/s40520-014-0233-z.

    Article  Google Scholar 

  • Kortebein, P., Symons, T. B., Ferrando, A., Paddon-Jones, D., Ronsen, O., Protas, E., et al. (2008). Functional impact of 10 days of bed rest in healthy older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63(10), 1076–1081.

    Article  Google Scholar 

  • Kuys, S. S., Dolecka, U. E., & Morrison, C. A. (2011). Appropriate seating for medical patients: An audit. Australian Health Review, 35(3), 316–319. https://doi.org/10.1071/AH10943.

    Article  Google Scholar 

  • Lafreniere, S., Folch, N., Dubois, S., Bedard, L., & Ducharme, F. (2015). Strategies used by older patients to prevent functional decline during hospitalization. Clinical Nursing Research. https://doi.org/10.1177/1054773815601392.

  • Lamarche, K., & Vallance, J. (2013). Prescription for physical activity a survey of Canadian nurse practitioners. The Canadian Nurse, 109(8), 22–26.

    Google Scholar 

  • Landefeld, C. S., Palmer, R. M., Kresevic, D. M., Fortinsky, R. H., & Kowal, J. (1995). A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. New England Journal of Medicine, 332(20), 1338–1344. https://doi.org/10.1056/Nejm199505183322006.

    Article  Google Scholar 

  • Levit, K., Wier, L., Stranges, E., Ryan, K., & Elixhauser, A. (2009). HCUP facts and figures: Statistics on hospital-based Care in the United States, 2007. Retrieved from http://www.hcup-us.ahrq.gov/reports.jsp

  • Lindgren, M., Unosson, M., Fredrikson, M., & Ek, A. C. (2004). Immobility – A major risk factor for development of pressure ulcers among adult hospitalized patients: A prospective study. Scandinavian Journal of Caring Sciences, 18(1), 57–64. https://doi.org/10.1046/j.0283-9318.2003.00250.x.

    Article  Google Scholar 

  • Matsuo, T., Sakaguchi, T., Ishida, A., Yuguchi, S., Saito, K., Nakajima, M., et al. (2015). Effect of in-hospital physical activity on cardiovascular prognosis in lower extremity bypass for claudication. Journal of Physical Therapy Science, 27(6), 1855–1859. https://doi.org/10.1589/jpts.27.1855.

    Article  Google Scholar 

  • McCullagh, R., Brady, N. M., Dillon, C., Horgan, N. F., & Timmons, S. (2016). A review of the accuracy and utility of motion sensors to measure physical activity of frail, older hospitalized patients. Journal of Aging and Physical Activity, 24(3), 465–475. https://doi.org/10.1123/japa.2014-0190.

    Article  Google Scholar 

  • McDonald, E. G., Dounaevskaia, V., & Lee, T. C. (2014). Inpatient attire: An opportunity to improve the patient experience. JAMA Internal Medicine, 174(11), 1865. https://doi.org/10.1001/jamainternmed.2014.4513.

    Article  Google Scholar 

  • Mortimer, J., & Green, M. (2015, October). The health and care of older people in England 2015. Age UK.

    Google Scholar 

  • Mudge, A. M., Giebel, A. J., Mgt, M. A., & Cutler, A. J. (2008). Exercising body and mind: An integrated approach to functional independence in hospitalized older people. Journal of the American Geriatrics Society, 56(4), 630–635. https://doi.org/10.1111/j.1532-5415.2007.01607.x.

    Article  Google Scholar 

  • Naylor, M., & Keating, S. A. (2008). Transitional care: Moving patients from one care setting to another. The American Journal of Nursing, 108(9 Suppl), 58–63. https://doi.org/10.1097/01.NAJ.0000336420.34946.3a.

    Article  Google Scholar 

  • Nitz, J. C., & Low Choy, N. (2008). Falling is not just for older women: Support for pre-emptive prevention intervention before 60. Climacteric, 11(6), 461–466. https://doi.org/10.1080/13697130802398517.

  • Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26(4), 645–692. https://doi.org/10.1016/j.cger.2010.06.005.

    Article  Google Scholar 

  • Ong, T., Anand, V., Tan, W., Watson, A., & Sahota, O. (2016). Physical activity study of older people in hospital: A cross-sectional analysis using accelerometers. European Geriatric Medicine, 7(1), 55–56. https://doi.org/10.1016/j.eurger.2015.10.008.

    Article  Google Scholar 

  • Ottenbacher, K. J., Smith, P. M., Illig, S. B., Linn, R. T., Ostir, G. V., & Granger, C. V. (2004). Trends in length of stay, living setting, functional outcome, and mortality following medical rehabilitation. JAMA, 292(14), 1687.

    Article  Google Scholar 

  • Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331. https://doi.org/10.1097/NCQ.0b013e3181a4f79b.

    Article  Google Scholar 

  • Peiris, C. L., Taylor, N. F., & Shields, N. (2012). Additional Saturday allied health services increase habitual physical activity among patients receiving inpatient rehabilitation for lower limb orthopedic conditions: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 93(8), 1365–1370. https://doi.org/10.1016/j.apmr.2012.03.004.

    Article  Google Scholar 

  • So, C., & Pierluissi, E. (2012). Attitudes and expectations regarding exercise in the hospital of hospitalized older adults: A qualitative study. Journal of the American Geriatrics Society, 60(4), 713–718. https://doi.org/10.1111/j.1532-5415.2012.03900.x.

    Article  Google Scholar 

  • Tolson, D., Smith, M., & Knight, P. (1999). An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: A multi-method design. Journal of Advanced Nursing, 30(5), 1127–1136. PubMed PMID: 10564412.

    Article  Google Scholar 

  • Toots, A., Littbrand, H., Lindelöf, N., Wiklund, R., Holmberg, H., Nordström, P., et al. (2016). Effects of a high-intensity functional exercise program on dependence in activities of daily living and balance in older adults with dementia. Journal of the American Geriatrics Society, 64(1), 55–64. https://doi.org/10.1111/jgs.13880.

    Article  Google Scholar 

  • Tudor-Locke, C., Craig, C. L., Aoyagi, Y., Bell, R. C., Croteau, K. A., De Bourdeaudhuij, I., et al. (2011). How many steps/day are enough? For older adults and special populations. The International Journal of Behavioral Nutrition and Physical Activity, 8, 80–80. https://doi.org/10.1186/1479-5868-8-80.

    Article  Google Scholar 

  • Turner-Stokes, L. (2007). Cost-efficiency of longer-stay rehabilitation programmes: Can they provide value for money. Brain Injury, 21(10), 1015–1021. https://doi.org/10.1080/02699050701591445.

    Article  Google Scholar 

  • VanWormer, J. J., Pronk, N. P., & Kroeninger, G. J. (2009). Clinical counseling for physical activity: Translation of a systematic review into care recommendations. Diabetes Spectrum, 22(1), 48–55.

    Article  Google Scholar 

  • Villumsen, M., Jorgensen, M. G., Andreasen, J., Rathleff, M. S., & Molgaard, C. M. (2015). Very low levels of physical activity in older patients during hospitalization at an acute geriatric Ward: A prospective cohort study. Journal of Aging and Physical Activity, 23(4), 542–549. https://doi.org/10.1123/japa.2014-0115.

    Article  Google Scholar 

  • Zisberg, A., Shadmi, E., Sinoff, G., Gur-Yaish, N., Srulovici, E., & Admi, H. (2011). Low mobility during hospitalization and functional decline in older adults. Journal of the American Geriatrics Society, 59(2), 266–273. https://doi.org/10.1111/j.1532-5415.2010.03276.x.

    Article  Google Scholar 

  • Zisberg, A., Shadmi, E., Gur-Yaish, N., Tonkikh, O., & Sinoff, G. (2015). Hospital-associated functional decline: The role of hospitalization processes beyond individual risk factors. Journal of the American Geriatrics Society, 63(1), 55–62. https://doi.org/10.1111/jgs.13193.

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Anna Barker & Sze-Ee Soh

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  1. Anna Barker
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  2. Sze-Ee Soh
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Editor information

Editors and Affiliations

  1. Department of Psychology, Bournemouth University, Poole, United Kingdom

    Samuel R. Nyman

  2. Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

    Anna Barker

  3. Department of Physiotherapy, Monash University, Frankston, Victoria, Australia

    Terry Haines

  4. School of Health Sciences, City, University of London, London, United Kingdom

    Khim Horton

  5. Centre for Innovative Ageing, Swansea University, Swansea, United Kingdom

    Charles Musselwhite

  6. Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland

    Geeske Peeters

  7. College of Health and Life Sciences, Brunel University, Uxbridge, United Kingdom

    Christina R. Victor

  8. Institute of Psychogerontology, Friedrich-Alexander-University Erlangen-Nuremberg, Nuremberg, Germany

    Julia Katharina Wolff

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Barker, A., Soh, SE. (2018). Promoting Physical Activity Among Older People in Hospital. In: Nyman, S., et al. The Palgrave Handbook of Ageing and Physical Activity Promotion. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-71291-8_19

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  • DOI: https://doi.org/10.1007/978-3-319-71291-8_19

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  • Publisher Name: Palgrave Macmillan, Cham

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